• MEMBERSHIP APPLICATION FORM - NBVI - Long Bay

  • Confidentiality: Any Confidential information requested is for our records and for the funding our organization receives. The answers you provide will be kept completely confidential. Your cooperation providing this information is both appreciated and necessary. Required fields are denoted with an asterisk(*)
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  • The STA also uses the following fields to learn more about your child. Please one item from each group below
  • Medical Information

  • Please enter N/A if information is unavailable, and enter all 0's for phone number if no physician available.
  • Pickup Information

  • I have read the complete application, understand the rules of the STA and request that my son/daughter be admitted into membership. Although every effort will be made to prevent injury, if an injury should occur to my child while participating in water based activities, I agree to hold STA, its agents and employees, and any volunteers/employees harmless. CONDUCT Swimmer and Parent will: Agree to abide by the code of conduct. Never argue with or verbally abuse an official. Always use the appropriate rules and guidelines to resolve a dispute. Conduct yourself in a sportsman-like manner and respect fellow swimmers, coaches, managers, staff, officials and the achievement of opponents. Do not bully or take unfair advantage of another competitor. Cooperate with your instructor, coach, and classmates. Refrain from possessing, consuming prohibited substances while in STA programmes or events. Do not consume or purchase alcohol and tobacco while in STA camps/sessions or. Any breach of the Code of Conduct, or any part of it, may result in disciplinary action under the STA, Regulations and policies. I grant the STA the unlimited right to use and/or reproduce photographs or likenesses in any legal manner for the internal or external promotional and information activities of the STA. I also agree to allow my child to be interviewed and/or photographed by representatives of the external news media in relation to any and all coverage of in which he/she is involved. I also agree to allow my child's work and/or photograph to be published on the STA Web site/Internet pages, and publications. I further understand that by signing this release, I waive any and all present or future compensation rights to the use of the above stated material(s PLEASE NOTE THAT FEES ARE NOT TRANSFERABLE NOR REFUNDABLE. FEES ARE DUE IN ADVANCED THE OF EACH MONTH
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